What does a labor & delivery nurse do?
Labor and delivery nurses (L&D), also known as obstetric nurses (OB), are an integral part of the care team responsible for caring for the pregnant patient and child. Though the labor and delivery nurse job description may vary depending on hospital location and size, most labor and delivery RNs will work with women in triage, antepartum mothers, intrapartum mothers, surgical patients, and postpartum mother/baby couplets.
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Labor and delivery nurse job description
- Assess patients in triage for preterm labor, active labor, rupture of waters, pregnancy complications, or co-existing issues
- Assist in maintaining pregnancy in antepartum mothers
- Fetal assessment and monitoring
- Maternal physical assessment(s)
- Manage patients in labor, including induction assistance, epidural assistance, pain management, education, and delivery support
- Assist and circulate in operating room for cesarean sections, tubal, and emergency obstetric and gynecological procedures
- Medication administration and immunizations
- Patient education related to medications, labor, pushing, delivering, and postpartum care of mother and baby
- Newborn care and assessment for healthy infant
- Breastfeeding and postpartum support/management
- Charting via electronic medical records
- Assist with fetal demise
- Collaboration with care management team, including anesthesiologist, physician or midwife, lactation nurse, and charge nurse
Associated care team
Though L&D nurses have a lot of autonomy, they still work intimately with a variety of different providers and individuals. The L&D nurse is responsible for updating and communicating with the patient’s OBGYN/midwife, the charge nurse, the anesthesiologist (or certified registered nurse anesthetist (CRNA)), the lactation nurse, the delivery nurse (if there is one), the neonatal nurse practitioner (NNP) and the family.
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Labor and delivery nurse workplace
The most common place of work for a L&D nurse is an acute care hospital. Many hospitals have units specifically for the pregnant population. In one of these units, L&D nurses may find themselves working in triage rooms, antepartum rooms, the operating room, the labor room, the infant nursery or the postpartum rooms. Shifts are commonly 8-hours, 10-hours or 12-hours. If a nurse does not work in a maternity specific unit, they may find that they float around the hospital, working with both pregnant patients and non-pregnant patients.
Labor and delivery nurse salary & job outlook
Per the U.S. Bureau of Labor Statistics (BLS), the 2018 median pay for a registered nurse was $71,730/year. The BLS also expects the demand for nurses to grow at a rate of 12% (through 2028), which is much faster than the average for all occupations. Note that these numbers are not specific to the L&D specialty, nor do they account for geographical location, nurse level of education, traveling nurses, or any additional credentials or certifications the nurse professional holds. Each of these factors can have a significant impact on nurse salary.
How to become a labor & delivery nurse
Currently, the Institute of Medicine (IOM) has a 2020 goal that 80% of registered nurses (RN) be bachelor’s prepared professionals. While the United States continues to work towards that goal, there are currently two common educational paths to professional RN practice.
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Labor and delivery nurse education
Associates Degree Nurse (ADN)
At the minimum, one must achieve an ADN and pass the NCLEX-RN exam before being eligible for a RN license. ADN programs typically take two years to complete (after two years of the appropriate prerequisites). ADN programs are usually offered through community colleges and include coursework online, in the classroom, lab work, clinical rotations, and practicum experiences.
Bachelor of Science in Nursing (BSN)
To maintain competitive advantage as well as meet the IOM mandate, most RNs pursue a BSN for nursing practice. BSN programs usually take four years to complete. There are also “bridge” programs, which take anywhere from 12-24 months, that allow a student to move from an ADN to a BSN or Master of Science in nursing (MSN). BSN programs are offered at brick and mortar campuses and online. Much like an ADN program, they are a combination of classroom work, lecture, labor work, clinical experiences, and practicums.
Master of Science in Nursing
An MSN is not required for professional L&D nursing practice. However, many nurses choose to complete a bridge program or work directly towards an MSN, as this education opens up leadership, education, and administrative nursing opportunities.
Internships & practicums
If possible, a student who desires to work in obstetrics should seek out an obstetric experience for their senior/final practicum. These practicum experiences are a chance to apply what has been learned in school, as well as dive deeper into the specific area a student believes they’d like employment.
Labor and delivery nurse certifications
There are three certifications many L&D RNs (or those who desire a L& D position) may choose to pursue, either to further their education or to achieve competitive advantage in the job application process.
NCC Credential in Inpatient Obstetric Nursing (RNC-OB)
This credential can be earned after a nurse has a minimum of two years with OB experience. The test is a competency-based exam that tests OB specific knowledge. Once earned, the credential must be renewed every 3 years with required continuing education credits completed as well.
Certification in Electronic Fetal Monitoring (C-EFM)
This examination is intended to test the specialty knowledge and knowledge application related to electronic fetal monitoring and interpretation of that data. This certification is maintained on a three years cycle through continuing education.
Neonatal Resuscitation Program® (NRP®)
A NRP certification program combines online testing, case based simulation, and hands on simulations and debriefing. The different testing environment(s) should focus on leadership, communication, and team-work skills in emergency neonatal situations. A NRP certification is valid for two years.
The world of L&D nursing is a highly specialized position, in which the nurse has the sweet privilege of being able to care for women, men, and their families on some of their very best days. It is not uncommon to find that many nurses who land in OB are extremely passionate and never leave the area of work. If you believe you share this passion, obstetrics and women’s health may be an area that can bring you joy for your whole career.
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